September 1967

The Carrier State and Type-Specific Immunity in Streptococcal Disease

Author Affiliations

Concord, Mass
From the Emerson Hospital, Concord, Mass, and the Acton Medical Associates, Acton, Mass. Dr. Harvey is also affiliated with Boston University School of Medicine.

Am J Dis Child. 1967;114(3):229-243. doi:10.1001/archpedi.1967.02090240043001

THE RELATIONSHIP between group A hemolytic streptococci and a host population has not yet been completely explained. That the organisms can cause disease is well known, but that they can exist for months in the throats of healthy individuals, particularly of children, is less well understood. The clinician, believing that a pathogen is always undesirable, is perplexed when he discovers that his "well" children can have the same type, in the same quantity, as his sick patients. He may think that this is a sign of future disease, either pharyngitis or one of the sequelae, and will give penicillin as a prophylactic measure. He may also think that the "carrier," unharmed himself, may be a source of infection to others.

We have presented evidence that these carriers do not necessarily transmit their organisms to their household associates.1,2 We have found that certain families have abundant streptococci, and that others

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